286065 (BLCK)FIELD OFFICE
DEPARTMENT OF BUILDING & SAFETY.
BUILDING PERMIT ,.,,, ,.,T" ,ter n,ven�,n�' '
[
PERMIT NO.
6651
OWNER
J311?40 P rrd
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COMMUNITY
: 1A4 -1,b-
r
DATE
1AIAoFI-76
CONSTRUCTION ESTIMATE
NO. ELECTRICAL FEES
NO. PLUMBING FEES
M H PERMIT. FEE
is
t
"
c.
IST FL.
2ND FL.
POR.
GAR.
CAR P.
WALL' SQ.
ESTIMATED CONSTRUCTION
SQ. FT. @ $.'
UNITS
F.C.
SUPP. TO PERMIT
SQ. FT. YARD SPKLR SYSTEM
-@
SQ. FT. @ MOBILEHOME .SVC. BAR SINK `
COPIES
SQ. FT. @ POWER OUTLET ROOF DRAINS
SQ. FT. @ DRAINAGE PIPING
LEGAL DESCRIPTION '
FT. @ DRINKING FOUNTAIN
DBL
SQ. FT. @ URINAL
VALUATION $ WATER PIPING
ZONE
SET BACK
NOTE: Not to be Used as.property tax valuation
SWIM POOL, PVT
FLOOR DRAIN
�CK BY
I.
MECHANICAL FEES
SWIM POOL, COMM
WATER SOFTENER
'PLAN CHECK FEE
VENT SYSTEM ❑ FAN ❑ EVAP. COOL ❑ HOOD
SIGN
WASHER (AUTO) (DISH)
.PLAN NO.
PLAN CHECKER
APPLIANCE ❑ DRYER
`
GARBAGE DISPOSAL
DBL
$
FURNACE ❑ UNIT Cl WALL ❑ FLOOR ❑ SUSPENDED
NAME OF CONST. LENDER BRANCH
LAUNDRY TRAY
NO LENDER INVOLVED
•
AIR HANDLING UNIT - CFM
IDLE METER
KITCHEN SINK
ADDRESS CITY
ABSORPTION SYSTEM B.T.U.
TEMP USE PERM SVC
WATER CLOSET
$
COMPRESSOR E::� HP
POLE, TEMP/PERM
LAVATORY
'SPECIALINSP
-DEMOLITION
REGISTRATION
HEATING SYSTEM ❑ FORCED ❑ GRAVITY
AMPERES SERV ENT
SHOWER
ADDRESS ADDRESS
1
BOILER B.T.U.
SQ.FT. @ a
BATH TUB
PLUMBING FEE
DBL
$
SQ.FT. @.: ¢
WATER HEATER
ZIP CODE
TOTAL FEES $
CASH ❑CHECK .❑N.C.❑
R
SWT.RESID @ 1'1/4¢
SEWAGE DISPOSAL '
NO,
AREA CODE
LICENSE A
SQ.FT.GAR @ 3/4¢
HOUSE SEWER
SEWAGE SYSTEM
T LL -
P
GAS PIPING
PERMIT FEEPERMIT
FEE
PERMIT FEE
DBL.
TOTAL FEES
IMOB.HM.FEEI
MICRO FEE
MECH. FEE PL. CK. FEE
CONST. FEE ELECT. FEE
SMI. FEE
FEE
PLUMB. FEE
F I M A M J J --A S O N D
JOB ADDRESS - SP NO
flj -J25, k4slo,/ N
OWNER
J311?40 P rrd
76
•��
COMMUNITY
: 1A4 -1,b-
VALUATION
00..
DATE
1AIAoFI-76
DST
1/
OFFICE
78
M H PERMIT. FEE
$
USE OF PERMIT
F.C.
SUPP. TO PERMIT
PE MI NO
MICROFILM FEE
COPIES
$
BOOK PAGE PARCEL
LEGAL DESCRIPTION '
MECHANICAL FEE
DBL
$
USE NO.
ZONE
SET BACK
LOT SIZEGRP
- -S
TYPE
�CK BY
I.
S
S I
R
'PLAN CHECK FEE
$
BOND AMT.
.PLAN NO.
PLAN CHECKER
FINAL DATE._ I SPECTOR
`
'CONSTRUCTION FEE.
DBL
$
NAME OF CONST. LENDER BRANCH
OFFICE
NO LENDER INVOLVED
ELECTRICAL FEE
DBL
$
ADDRESS CITY
STATE
.STRONG MOTION
INSTRUMENTATION FEE
$
\ OWNER/ GENT6 SIGNAT.I'1RE. CONTRACTOR
. ,-•
-
'SPECIALINSP
-DEMOLITION
REGISTRATION
RFE
$
ADDRESS ADDRESS
1
PLUMBING FEE
DBL
$
CITY ', ZIP CODE CITY
ZIP CODE
TOTAL FEES $
CASH ❑CHECK .❑N.C.❑
R
'TEL. NO. AREA
J�..�
CODE TEL,
AC,
NO,
AREA CODE
LICENSE A
RECEIVED BY TREES REQUIRED .
THIS'PERMIT SHALL BECOME VOID IF WORK IS NOT COMMENCED WITHIN 120 DAYS. CESSATION OF
WORK FOR 120 DAYS SHALL ALSO CAUSE PERMIT TO BECOME, VOID.
I HEREBY AGREE THAT ALL WORK IN CONNECTION WITH THIS PERMIT WILL BE DONE IN ACCORDANCE
WITH THE LAWS OF RIVERSIDE COUNTY AND THE STATE OF CALIFORNIA, I ALSO AGREE TO CARRY
SEWAGE SYSTEM
T LL -
P
COMPENSATION INSURANCE UPON MY EMPLOYEES. COMPLIANCE WITH THE LAWS OF THE STATE OF
CALIFORNIA COVERING CONTRACTORS IS ALSO GUARANTEED.
I HEREBY CERTIFY THAT THE INDIVIDUAL WHO PREPARED THE PLANS AND SPECIFICATIONS HAS DONE
FORM 284-20e (REV. 6-7e) SO IN ACCORDANCE WITH SECTION 5541 OF THE BUSINESS AND PROFESSIONS CODE OF THE STATE
OF CALIFORNIA.